It's called many names, but the official health care reform law, signed in 2010, is called the Patient Protection and Affordable Care Act (PPACA or just ACA) or Obamacare. It was designed to improve access to health care for everyone. While some parts of the law are already in place, most of the major provisions of ACA become effective in 2014. These changes are aimed at making health coverage more accessible and affordable for many more people. They include the creation of Health Insurance Marketplaces (also called Exchanges), coverage of Essential Health Benefits (EHBs) and individual tax credits. There will be even more changes coming over the next several years.
With the ACA, you cannot be denied coverage, or pay a higher rate, based on a pre-existing condition. If you currently don't have coverage through an employer plan, Medicare or Medicaid, you will have to buy it on your own.
Confused yet? If so, don’t feel bad. You’re not alone - there are a lot of changes happening. But you have come to the right place - it is our job to “get it”. And HAP is here to help make sure that you do too.
Health plans already have broader coverage because of the ACA. Here are some of the new benefits available now:
Time to get health insurance.
Most people will be required to have health insurance starting in 2014 or face tax penalties. You may also have to pay a penalty for every month you are uninsured starting in 2014.
We’ve got you covered. Guaranteed!
In 2014, health plans cannot deny coverage or charge a higher premium to someone with a pre-existing medical condition. These protections are commonly referred to as guaranteed issue.
What is covered?
Health plans will also be required to cover Essential Health Benefits or EHBs, which include at least the following 10 categories of health care services:
There may be help available.
If you buy coverage through the Health Insurance Marketplace, you may be eligible for cost savings based on your family size and how much your family earns. The lower your income, the higher your savings may be. If you are eligible, you will receive a cost savings that can be applied directly to your monthly premiums. You may also be eligible for lower copays, coinsurance and deductibles. To learn if you may qualify for these savings, use our Get a Quote tool.
The metal tiers: Bronze, Silver, Gold and Platinum
Starting in 2014, health plans will be ranked using metal tiers: Bronze, Silver, Gold and Platinum. The idea behind "metal level plans," or metal tiers, is to allow consumers to compare health plans with similar coverage value (the technical term is actuarial value).
What this means is that health plans offered to individuals and families through HAP or the Health Insurance Marketplace will be grouped in different metal tiers based on the percentage of health care costs the health plan covers.
When to buy health insurance:
Individuals purchasing their own coverage, either directly from a health plan or through the Health Insurance Marketplace, will only be able to apply for or change health plans during the "open enrollment period" each year. The first open enrollment period for health plans effective in 2014 began on October 1, 2013 and will end on March 31, 2014.
Where to buy health insurance:
There are three ways to buy a health care plan - through insurance companies like HAP, through the Health Insurance Marketplace, or through an insurance agent. There are also Navigators available to help guide you through the Health Insurance Marketplace.
